Drug interactions
Cyclosporin + Tacrolimus
Severity: Contraindicated
Cyclosporin and Tacrolimus: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are calcineurin inhibitors and together they increase nephrotoxicity, neurotoxicity and over-immunosuppression. Cyclosporine can also raise tacrolimus levels, and the two should not be given together.
What this interaction means in plain words
Cyclosporin and Tacrolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Cyclosporin belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive calcineurin inhibition and toxicity, with competition for CYP3A4 and P-glycoprotein altering exposure of either drug.
What to do
Do not combine the two. When switching, stop one and wait at least 24 hours before starting the other, guided by drug levels and renal function.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
Other interactions of Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine + Tacrolimus Contraindicated
Frequently asked questions
Can I take Cyclosporin with Tacrolimus?
MediHelp rates the interaction as contraindicated. Cyclosporin and Tacrolimus are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Both are calcineurin inhibitors and together they increase nephrotoxicity, neurotoxicity and over-immunosuppression. Cyclosporine can also raise tacrolimus levels, and the two should not be given together.
How serious is the interaction between Cyclosporin and Tacrolimus?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not combine the two. When switching, stop one and wait at least 24 hours before starting the other, guided by drug levels and renal function.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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